Justice For Mental Health (and homework for Matt Gurney) UPDATED

Having a Twitter back-and-forth with Matt Gurney about police and identifying mentally ill individuals.

Gurney makes a good point that no matter what, officers will have to handle the person in front of them, regardless of what the backstory is - and they won't necessarily have oodles of time to decide what's motivating behaviour (illness, drugs, a stressful day).

Here are a couple of ideas I put down that eventually morphed into a slide deck that isn't so postable to a blog:

JUSTICE FOR MENTAL HEALTH

THE REALITY

•       Front line police officers are often first and last responders to Emotionally Disturbed Person (EDP) calls

•       Without appropriate supports and education for police, these calls carry an unnecessary risk for both officers and EDPs

–      Post-Traumatic Stress (PTSD) for officers with impact on their work, health and families

–      Avoidable incarceration, injury and fatalities for EDPs

•       Toronto officers receive annual mental health training as part of a two-day “use of force” program.  Training includes role-play but no exposure to persons with lived mental illness experience or education about the biology or behaviour of mental illnesses

THE OPPORTUNITY

Expand existing Police training and provide additional online support tools

Training:

·         Resiliency and stress management

o   (potential partners: Millbrook Canada, Centre for Applied Neuroscience Canada (CANC), Justice Mental Health Program (JAMH), Canadian Positive Psychology Association (CPPA)

o   Basic training regarding brain function and abnormal psychology (CANC + JMHA)

·         Exposure to EDPs in safe environments (eg. Rounds at CAMH)

Online Support Tools:

·         Modularized online training (including videos presenting behaviour of psychological conditions for exposure)

o   Modular E-Learning programs would reduce manpower lost to training time issues

·         Online map-based portal aggregating all Toronto mental health, health and related justice service providers

·         Smart-phone App that provides an easy-to-navigate chart of mental illnesses, symptoms, conditions, triggers and suggested responses (developed in conjunction with E-Learning program)

ACTION ITEMS

-          Develop a pilot program (including model web portal/App) for  Toronto Police Divisions 51 + 52 (build on existing Mobile Crisis Intervention Team program)

o   Partners; Toronto Police, City of Toronto, additional mental health service providers


UPDATE - Look at this, there is already solid material out there that could be followed up on:

HALLUCINATIONS:

“My hallucinations are not always there but when I see and hear imaginary things, it is very frightening and painful to me. I know some people think I can just control myself and tell myself they are not real. But I can’t will them away. They are real to me when I am experiencing them.”
– CLIENT

Definition:
Person senses perceptions that do not exist in the real world such as:
- feel such as bugs crawling under the skin
- smell such as smoke or gas
- taste such as poison in food
- sight such as visions of God, other persons, etc.
- hearing such as voices telling the person to do something auditory the most frequently encountered hallucination involves the auditory sense, i.e. hearing


Recognition:
• has faulty sensory perceptions, i.e., hears, sees, smells, feels things that do not exist
• talks to self
• appears preoccupied and unaware of surroundings
• has difficulty following conversations and instructions 
• momentary or extended lapses in attention, as if listening to something
• misinterprets words and actions of others
• may isolate self 

• may use radio or other sounds to tune out voices

Police Response Strategies:
• isolate and contain
• do not invade personal space 
• do not touch without permission or stand too close
• speak slowly and quietly using simple concrete language
• avoid verbal confrontation
• remember it may take the individual longer to process information
• instruct to “listen to my voice, do not listen to the other voices”
• explain your actions
• ask questions:
    – “Are you hearing voices other than mine?” 
    – “What are they telling you?” 
    – “What do you see, feel, taste?”
• reduce confusion, i.e., bright lights, television, radio
• be aware that stress may increase hallucinations
• address the person by name/if do not know it, ask how they would wish to be addressed

• do not pretend that you are experiencing the hallucination along with the person

Remember – you are the grounding in reality. Respond by saying, “I don’t hear the voices, but
understand that you do.” It is critical to ask questions regarding the content of the message in that it may be a directive to hurt someone including you. Try to get a sense of how they feel and how you could help. 

Remember – the person may not be able to adequately process the information or may have recent memory problems making it difficult to follow instructions.


UPDATED:  “Real life in the police services is not a television drama,” wrote Blair near the end of the ruling. “What took place here sullies the reputations of the many good officers in our country, whose work is integral to the safety and security of our society.”

Introducing Guardly - A Look At the Future of Public Services?

Students can use the Guardly app to alert security to campus emergencies. The app will automatically transmit details like their location, identification and profile information (such as any allergies, medical conditions etc.) making it faster and more efficient for security personnel to respond accordingly. During an incident, dispatchers can also speak with a caller by phone or engage in a conversation by secure instant messaging.

Guardly is a brilliant, innovative application of social media and new technology to a societal need.  Not only does it allow for services to get to where they're required and fast - it brings the whole conversation to the intended user in a way that is accessible and intuitive for them.  This is the next iteration of the whole "get your health card like a pizza" theme redesigning social services to mesh with how people behave rather than trying to train them to behave in a way that works for services.

Now, how can this concept be expanded to broader applications, boosting the economy by creating new markets and improving service delivery, benefiting both users and providers?  If you read my blog, you know that I have proposed the creation of a map-based, user-friendly online service aggregate, something the US is now pursuing with their digital government strategy.  When Canada gets around to building its own model, we'll need an App that connects those services with users in their daily lives, via mobile device.  Guardly (or tools like it) can be the connective tissue between users and online service delivery.

That's big-picture; on a more immediate level, there's a ready-made opportunity that would allow Guardly to test out the broader application of their product in a related field (security and safety), helping to address a major social issue at the same time.  That field is the interaction between our police, mental health service providers and persons suffering from mental illness themselves.

At Gerard Kennedy's recent Mental Health Matinee, I had the opportunity to view The Interventionists, a documentary that follows Toronto's Mobile Crisis Intervention Team (MCIT) as they dealt with calls involving Emotionally Disturbed People (EDPs).  It was pretty shocking stuff, though none of it unexpected.  We know what happens on our streets, even if we choose to ignore it.  After the screening, I had a chance to speak with one of the MCIT Officers, Mike Zawerbry, about the work (which he was very passionate about) and ask if he felt there were other tools he could use to enhance his services. 

Officer Zawerbry said that having one online portal that aggregates what mental health services are available in town by type and location would be incredibly useful.  If that portal could include tips on recognizing mental illness symptoms and suggested responses for de-escalation responses, that would also be helpful.  For it to be of real-time use, this portal would have to be accessible by mobile phone and intuitive to use.  You can't be fumbling over functions when there's someone trying to harm themselves or someone else in front of you.

The MCIT program is a partnership between the Toronto Police and St. Joseph's Health Centre.  Completely separate, the Schizophrenia Society of Ontario's Justice Mental Health Program (JMHP) provides support and training for people on both sides of the law (including families) related to mental health.  Same sort of deal; if the services JMHP and some self-guidance tools were available, would such a service help de-escalate problems or provide more rapid support access?  If individuals with diagnoses of mental illness had their own profile information on their personal devices, could they use that as a self-help and help-seeking tool when they have moments of distress?

An App like Guardly could be tweaked to help fill this gap.  Would such a service help keep people out of hospitals, the justice system and jail cells, reducing service cost?  If so, would that be worth funding?  On the other side of the equation, how much could be saved in terms of unnecessary service use/preserving human dignity/maintaining safety and security?

Ontario is looking for innovative ways to stimulate the economy; it's looking to improve service delivery and provide additional support for their front-line workers - they're also looking to improve quality of life outcomes in the province. 

Guardly might just have an App for that.